HIV-2 viral tropism influences CD4+ T cell count regardless of viral load

Treviño, Ana; Soriano, Vicente; Poveda, Eva; Parra, Patricia; Cabezas, Teresa; Caballero, Estrella; Roc, Lourdes; Rodríguez, Carmen; Eiros, Jose M.; Lopez, Mariola; De Mendoza, Carmen
August 2014
Journal of Antimicrobial Chemotherapy (JAC);Aug2014, Vol. 69 Issue 8, p2191
Academic Journal
Background HIV-2 infection is characterized by low plasma viraemia and slower progression to AIDS in comparison with HIV-1 infection. However, antiretroviral therapy in patients with HIV-2 is less effective and often fails to provide optimal CD4 recovery. Methods We examined viral tropism in persons with HIV-2 infection enrolled in the HIV-2 Spanish cohort. Viral tropism was estimated based on V3 sequences obtained from plasma RNA and/or proviral DNA. Results From a total of 279 individuals with HIV-2 infection recorded in the Spanish national register, 58 V3 sequences belonging to 42 individuals were evaluated. X4 viruses were recognized in 14 patients (33%). Patients with X4 viruses had lower median CD4+ cell counts than patients with R5 viruses [130 (17–210) versus 359 (180–470) cells/mm3; P = 0.007]. This was true even considering only the subset of 19 patients on antiretroviral therapy [94 (16–147) versus 184 (43–368) cells/mm3; P = 0.041]. In multivariate analysis, significant differences in CD4+ cell counts between patients with X4 and R5 viruses remained after adjusting for age, gender, antiretroviral therapy and viral load. Conclusions The presence of X4-tropic viruses in HIV-2 infection is associated with low CD4+ cell counts, regardless of antiretroviral treatment. Along with CD4+ cell counts, viral tropism testing may assist decisions about when to initiate antiretroviral therapy in HIV-2-infected individuals.


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